Kidney & Ureteral Stones
Prognosis
The success of any surgical repair is not 100%. Reported success with endopyelotomy ranges from 50 to 88%. Both open and laparosopic pyeloplasty provide 94% long-term success. Failures are usually detected within the first year of surgery, however there can be late failures and follow-up imaging is required on a yearly basis for 5 years following surgery. The goal of surgical correction is to prevent further damage and further decrease in function of the kidney. Surgery will not reverse damage which has already occurred. Also 30% of patients who presented with pain will still have some degree of back discomfort after repair. This is usually much better than that experienced preoperatively. The mechanism for this persistent pain is not known, but occurs after any type of surgery for repair.
Follow-up
Patients with a history of ureteropelvic junction obstruction should be followed with imaging studies such as a nuclear medicine renal scan, ultrasound or intravenous pyelogram. Depending on the type of procedure, recurrent scar tissue may develop at the site of surgery. Symptoms such as back pain, blood in the urine or recurrent urinary tract infections should worked up with imaging studies.
